Diabetic Foot

Many people with diabetes have no problems with their feet. However, diabetes may affect your feet in a number of ways and in some cases can lead to serious complications so an annual check up with a chiropodist / podiatrist is good practice to ensure that all remains well.

How does diabetes affect the feet?

One of the early changes can be loss of sensation in your feet, often starting at the toes. This is known as ‘peripheral neuropathy’.

Another change that can occur is reduced blood flow to your feet.

Diabetes may also affect your ability to heal and reduce your natural ability to fight bacteria. Consequently, you should take particular care of any scratches, cuts or blisters on your feet.

What can I do to avoid these problems?

It is possible to prevent or delay changes affecting your feet if you follow medical advice and keep blood sugar, cholesterol and blood pressure levels within the target range set by your doctor. Your chances of doing this will be greatly increased if you do not smoke.

Consult your podiatrist immediately if you see any of the following in your feet:

A break in the skin or discharge

Any changes in the colour of the skin on the foot ( e.g. becoming paler, redder, more blue or black)

New swelling in your foot

If you usually have some loss of feeling in your feet and suddenly experience unexplained pain or discomfort, especially if the surrounding skin is warmer to the touch when compared with the same part of the other foot.

Simple steps for taking care of your feet

1. Always check your feet every day. It’s a good habit to get into and extremely important if you have lost sensation in your feet. Look for any colour changes or damage to the skin. If you see anything unusual or have a cut, scratch or blister, contact your podiatrist especially if it is not healing. The podiatrist would rather be consulted for a relatively trivial complaint early than for a more serious problem later.

2. Clean and dress any cuts, scratches or wounds. Remember diabetes may affect your ability to heal and reduce your natural ability to fight bacteria. Consequently, you should run water over the wound, dry the skin around the wound (but not the wound itself) and apply a sterile dressing before consulting your podiatrist or GP’s surgery.

3. Never go barefoot as you may step on a sharp object and cause damage. Each day get into the habit of checking and examining your shoes inside. Check your socks to avoid rough seams or mended areas; everything should fit smoothly and comfortably.

4. Ensure your shoes are a good fit. You should always wear shoes that do not mark the skin or cause you calluses, for example on the tops or side of the toes. When buying new shoes, get your feet measured. If suddenly you feel you need a smaller size shoe because your old size starts to feel loose, see your podiatrist as this may be an early sign of loss of feeling in your feet.

5. If you have corns and calluses visit a chiropodist / podiatrist regularly. Your podiatrist will remove any corns and calluses. Corns and calluses are signs of pressure on the skin and can lead to ulceration if untreated. Often, but not always, this will become evident by bruising underneath the skin. If you see such bruising make an urgent
appointment to see your podiatrist. Do not cut corns or calluses off your feet or use corn plasters that contain caustic agents. These increase substantially the risk of infection. See your podiatrist for help and advice.

6. If you are able to, cut your nails straight across and use an emery board. If you have difficulties or are troubled with an in-growing toenail consult a podiatrist.

Why have regular check ups on my feet?

If you have diabetes it is important that you have your feet checked at least once a year, so that you receive the appropriate level of care.

The chiropodist / podiatrist is in a position to give you appropriate advice and treatment; they can treat any corns, callous, ulcers or pressure sores which you may have developed.

Remember – your foot is checked to assess the risk of developing complications, and this is important.